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Preanalytical error

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https://www.readbyqxmd.com/read/29651205/errors-in-the-extra-analytical-phases-of-clinical-chemistry-laboratory-testing
#1
Annalise E Zemlin
The total testing process consists of various phases from the pre-preanalytical to the post-postanalytical phase, the so-called brain-to-brain loop. With improvements in analytical techniques and efficient quality control programmes, most laboratory errors now occur in the extra-analytical phases. There has been recent interest in these errors with numerous publications highlighting their effect on service delivery, patient care and cost. This interest has led to the formation of various working groups whose mission is to develop standardized quality indicators which can be used to measure the performance of service of these phases...
April 2018: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/29567661/quality-control-of-serum-and-plasma-by-quantification-of-4e-14z-sphingadienine-c18-1-phosphate-uncovers-common-preanalytical-errors-during-handling-of-whole-blood
#2
Xinyu Liu, Miriam Hoene, Peiyuan Yin, Louise Fritsche, Peter Plomgaard, Jakob S Hansen, Christos T Nakas, Andreas M Niess, Jens Hudemann, Michael Haap, Maimuna Mendy, Cora Weigert, Xiaolin Wang, Andreas Fritsche, Andreas Peter, Hans-Ulrich Häring, Guowang Xu, Rainer Lehmann
BACKGROUND: Nonadherence to standard operating procedures (SOPs) during handling and processing of whole blood is one of the most frequent causes affecting the quality of serum and plasma. Yet, the quality of blood samples is of the utmost importance for reliable, conclusive research findings, valid diagnostics, and appropriate therapeutic decisions. METHODS: UHPLC-MS-driven nontargeted metabolomics was applied to identify biomarkers that reflected time to processing of blood samples, and a targeted UHPLC-MS analysis was used to quantify and validate these biomarkers...
March 22, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29563672/assessment-of-bedside-transfusion-practices-at-a-tertiary-care-center-a-step-closer-to-controlling-the-chaos
#3
Dheeraj Khetan, Rahul Katharia, Hem Chandra Pandey, Rajendra Chaudhary, Rajesh Harsvardhan, Hemchandra Pandey, Atul Sonkar
BACKGROUND: Blood transfusion chain can be divided into three phases: preanalytical (patient bedside), analytical (steps done at transfusion services), and postanalytical (bedside). Majority (~70%) of events due to blood transfusion have been attributed to errors in bedside blood administration practices. Survey of bedside transfusion practices (pre-analytical and post analytical phase) was done to assess awareness and compliance to guidelines regarding requisition and administration of blood components...
January 2018: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/29512190/comparison-of-the-effect-of-gel-used-in-two-different-serum-separator-tubes-for-thyroid-function-tests
#4
Müjgan Ercan, Esra Fırat Oğuz, Emiş Deniz Akbulut, Mustafa Yilmaz, Turan Turhan
BACKGROUND: Selection and verification of blood collection tubes is an important preanalytical issue in clinical laboratories. Today, gel tubes are commonly used with many advantages, although they are known to cause interference in immunoassay methods. In this study, we aimed to compare SSTs of two different suppliers (Ayset clot activator & Gel and Becton Dickinson (BD) Vacutainer SST II advance) with reference tubes and evaluate the effect of storage time in terms of commonly used endocrine tests such as thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3)...
March 7, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29371778/evaluation-of-preanalytical-quality-indicators-by-six-sigma-and-pareto-s-principle
#5
Sweta Kulkarni, R Ramesh, A R Srinivasan, C R Wilma Delphine Silvia
Preanalytical steps are the major sources of error in clinical laboratory. The analytical errors can be corrected by quality control procedures but there is a need for stringent quality checks in preanalytical area as these processes are done outside the laboratory. Sigma value depicts the performance of laboratory and its quality measures. Hence in the present study six sigma and Pareto principle was applied to preanalytical quality indicators to evaluate the clinical biochemistry laboratory performance. This observational study was carried out for a period of 1 year from November 2015-2016...
January 2018: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/29346674/integrating-research-techniques-to-improve-quality-and-safety-in-the-preanalytical-phase
#6
Adolfo Romero, Juan Gómez-Salgado, José Andrés Domínguez-Gómez, Carlos Ruiz-Frutos
Background: Reducing errors in the preanalytical phase is difficult, which suggests the issue may be multidimensional. As such, qualitative research may be truly innovative in this context. Method: We carried out a descriptive study using a qualitative method incorporating 4 focus groups. Data analysis followed the principles of Grounded Theory. Results: We queried in each of the 4 focus groups collectively to identify weaknesses in the system...
March 21, 2018: Laboratory Medicine
https://www.readbyqxmd.com/read/29274328/preanalytical-and-analytical-challenges-in-gas-chromatographic-determination-of-cholesterol-synthesis-and-absorption-markers
#7
Tamara Gojkovic, Sandra Vladimirov, Vesna Spasojevic-Kalimanovska, Aleksandra Zeljkovic, Jelena Vekic, Jelena Arsenijevic, Ivana Djuricic, Sladjana Sobajic, Zorana Jelic-Ivanovic
INTRODUCTION: Cholesterol homeostasis disruption contributes to the development of different pathologies. Non-cholesterol sterols (NCSs) serve as cholesterol synthesis markers (desmosterol and lathosterol), and cholesterol absorption surrogate markers (campesterol, stigmasterol and β-sitosterol). The study aimed to resolve certain new pre-analytical and analytical problems and ensure a reliable and validated method. MATERIALS AND METHODS: Method optimization, validation and stability studies were executed in human serum and plasma...
March 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28984289/preanalytical-analytical-and-postanalytical-errors-in-the%C3%A2-measurement-of-irisin-levels-authors-reply
#8
Małgorzata Kałużna, Krzysztof Hoppe, Krzysztof Schwermer, Aisha Y Ibrahim, Krzysztof Pawlaczyk, Katarzyna Ziemnicka
No abstract text is available yet for this article.
September 29, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28984288/preanalytical-analytical-and-postanalytical-errors-in-the%C3%A2-measurement-of-irisin-levels
#9
Mehmet Kalayci
No abstract text is available yet for this article.
September 29, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28969112/pre-analytical-errors-at-the-chemical-pathology-laboratory-of-a-teaching-hospital
#10
Marlene A Tapper, James C Pethick, Lowell L Dilworth, Donovan A McGrowder
INTRODUCTION: The Chemical Pathology Laboratory at the University Hospital of the West Indies (UHWI) processes specimens received from inpatients, the outpatient department and other medical facilities in Jamaica. Specific rejection criteria are used to determine samples unsuitable for analysis. It has been noted that despite efforts to reduce the number of unacceptable samples received in the laboratory, the problem persists. AIM: The study seeks to provide empirical evidence of the inadequacies from which improvements can be formulated...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28967956/variability-and-error-in-cardiac-troponin-testing-an-aclps-critical-review
#11
REVIEW
Daniel S Herman, Peter A Kavsak, Dina N Greene
Objectives: To provide a comprehensive overview of the complexities associated with cardiac troponin (cTn) testing. An emphasis is placed on the sources of error, organized into the preanalytical, analytical, and postanalytical phases of the testing pathway. Controversial areas are also explored. Methods: A case scenario and review of the relevant literature describing laboratory considerations involving cTn testing are described. Results: Advanced comprehension of the specific assay used in a given laboratory is necessary for optimal reporting, utilization, and quality monitoring of cTn...
October 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28934512/increased-patient-satisfaction-and-a-reduction-in-pre-analytical-errors-following-implementation-of-an-electronic-specimen-collection-module-in-outpatient-phlebotomy
#12
Michalis Kantartjis, Stacy E F Melanson, Athena K Petrides, Adam B Landman, David W Bates, Bernard A Rosner, Ellen Goonan, Ida Bixho, Milenko J Tanasijevic
Background: Patient satisfaction in outpatient phlebotomy settings typically depends on wait time and venipuncture experience, and many patients equate their experiences with their overall satisfaction with the hospital. Methods: We compared patient service times and preanalytical errors pre- and postimplementation of an integrated electronic health record (EHR)-laboratory information system (LIS) and electronic specimen collection module. We also measured patient wait time and assessed patient satisfaction using a 5-question survey...
August 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28915106/making-sense-of-a-haemolysis-monitoring-and-reporting-system-a-nationwide-longitudinal-multimethod-study-of-68-australian-laboratory-participant-organisations
#13
Ling Li, Elia Vecellio, Stephanie Gay, Rebecca Lake, Mark Mackay, Leslie Burnett, Douglas Chesher, Stephen Braye, Tony Badrick, Johanna I Westbrook, Andrew Georgiou
BACKGROUND: The key incident monitoring and management systems (KIMMS) quality assurance program monitors incidents in the pre- and postanalytical phases of testing in medical laboratories. Haemolysed specimens have been found to be the most frequent preanalytical error and have major implications for patient care. The aims of this study were to assess the suitability of KIMMS for quality reporting of haemolysis and to devise a meaningful method for reporting and monitoring haemolysis...
September 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28893861/adrenal-venous-sampling-for-primary-aldosteronism-laboratory-medicine-best-practice
#14
REVIEW
Gregory Kline, Daniel T Holmes
Primary aldosteronism (PA) is the most common form of secondary hypertension and is critical to identify because when caused by an aldosterone-producing adenoma (APA) or another unilateral form, it is potentially curable, and even when caused by bilateral disease, antihypertensives more specific to PA treatment can be employed (ie, aldosterone antagonists). Identification of unilateral forms is not generally accomplished with imaging because APAs may be small and elude detection, and coincidental identification of a non-functioning incidentaloma contralateral to an APA may lead to removal of an incorrect gland...
November 2017: Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28888086/stability-of-routine-biochemical-analytes-in-whole-blood-and-plasma-serum-focus-on-potassium-stability-from-lithium-heparin
#15
Anne Marie Dupuy, Jean Paul Cristol, Bruno Vincent, Anne Sophie Bargnoux, Mickael Mendes, Pascal Philibert, Kadda Klouche, Stéphanie Badiou
BACKGROUND: Blood specimens are transported from clinical departments to the biochemistry laboratory by hospital courier service, sometimes over long distances. The aim of this study was to assess the stability of common biochemical analytes in venous blood under our routine transport conditions and to evaluate analyte stability after prompt or delayed centrifugation. METHODS: We investigated pre- and postanalytical contributions of 32 biochemical analytes in plasma and serum samples from 10 patients (healthy adults and patients from intensive care units)...
September 9, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28804816/preanalytical-issues-in-hemostasis-and-thrombosis-testing
#16
Giuseppe Lippi, Emmanuel J Favaloro
Hemostasis testing is critical to many hemorrhagic and thrombotic disorders, wherein laboratory diagnostics can provide critical information for diagnosis, prognostication, and therapeutic monitoring. Due to this crucial role in modern medicine, hemostasis tests should be carried out at their highest degree of quality, thus encompassing standardization and monitoring of all phases of the testing process. It is now clearly established that the preanalytical phase is the most critical and vulnerable part of the total testing process, since up to 70% of diagnostic errors are due to highly manual activities encompassing patient preparation and collection of biological samples, as well as handling, transportation, preparation and storage of blood specimens...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28694735/what%C3%A2-s-floating-on-my-plasma
#17
Janne Cadamuro, Helmut Wiedemann, Thomas K Felder, Cornelia Mrazek, Ulrike Kipman, Oberkofler Hannes, Elisabeth Haschke-Becher
We report on a preanalytical issue we encountered during routine clinical chemistry analyses, potentially leading to deviated analysis results and believe that it might help other laboratories to overcome similar problems. In a heparin-gel tube we measured an implausible glucose value of 0.06 mmol/L. Re-measurement of the same sample resulted in a glucose value of 5.4 mmol/L. After excluding an analytical error, we inspected the sample closer and found a white material as well as fatty droplets floating on the surface of the plasma tube...
June 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28680348/preanalytical-nonconformity-management-regarding-primary-tube-mixing-in-brazil
#18
Gabriel Lima-Oliveira, Gian Cesare Guidi, Andre Valpassos Pacifici Guimaraes, Jose Abol Correa, Giuseppe Lippi
BACKGROUND: The multifaceted clinical laboratory process is divided in three essential phases: the preanalytical, analytical and postanalytical phase. Problems emerging from the preanalytical phase are responsible for more than 60% of laboratory errors. This report is aimed at highlighting and discussing nonconformity (e.g., nonstandardized procedures) in primary blood tube mixing immediately after blood collection by venipuncture with evacuated tube systems. METHODS: From January 2015 to December 2015, fifty different laboratory quality managers from Brazil were contacted to request their internal audit reports on nonconformity regarding primary blood tube mixing immediately after blood collection by venipuncture performed using evacuated tube systems...
January 2017: Journal of Medical Biochemistry
https://www.readbyqxmd.com/read/28593925/intensive-educational-efforts-combined-with-external-quality-assessment-improve-the-preanalytical-phase-in-general-practitioner-offices-and-nursing-homes
#19
Una Ørvim Sølvik, Wenche Iren Bjelkarøy, Kari van den Berg, Anne Lise Saga, Helle Borgstrøm Hager, Sverre Sandberg
BACKGROUND: Errors in the preanalytical phase in clinical laboratories affect patient safety. The aim of this study was to evaluate the effect of intensive educational efforts together with external quality assessment (EQA) of the preanalytical phase from 2013 to 2015 to improve patient identification in primary health care in Norway. In addition, routines for venous and capillary blood sampling were investigated. METHODS: A preanalytical EQA was circulated in 2013 by the Norwegian Quality Improvement of Laboratory Examinations (Noklus) to general practitioner offices and nursing homes (n=2000) to obtain information about important issues to focus on before launching an intensive educational program with courses, posters and visits in 2013-2015...
October 26, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28502727/concordance-between-research-sequencing-and-clinical-pharmacogenetic-genotyping-in-the-emerge-pgx-study
#20
Laura J Rasmussen-Torvik, Berta Almoguera, Kimberly F Doheny, Robert R Freimuth, Adam S Gordon, Hakon Hakonarson, Jared B Hawkins, Ammar Husami, Lynn C Ivacic, Iftikhar J Kullo, Michael D Linderman, Teri A Manolio, Aniwaa Owusu Obeng, Renata Pellegrino, Cynthia A Prows, Marylyn D Ritchie, Maureen E Smith, Sarah C Stallings, Wendy A Wolf, Kejian Zhang, Stuart A Scott
There has been extensive debate about both the necessity of orthogonal confirmation of next-generation sequencing (NGS) results in Clinical Laboratory Improvement Amendments-approved laboratories and return of research NGS results to participants enrolled in research studies. In eMERGE-PGx, subjects underwent research NGS using PGRNseq and orthogonal targeted genotyping in clinical laboratories, which prompted a comparison of genotyping results between platforms. Concordance (percentage agreement) was reported for 4077 samples tested across nine combinations of research and clinical laboratories...
July 2017: Journal of Molecular Diagnostics: JMD
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